title: Detection of breast cancer with conventional mammography and contrast-enhanced MR imaging.
abstract: The aim of this study was to compare the diagnostic performance of conventional mammography and dynamic contrast-enhanced fast 3D gradient-echo (GRE) MRI regarding the detection and characterization of breast lesions relative to histopathologic analysis and to assess the results of a combined evaluation of both methods. fifty consecutive patients with 63 histopathologically verified breast lesions underwent dynamic contrast-enhanced GRE MRI in addition to routine conventional mammography. All lesions were classified by both methods on a five-point scale as benign or malignant, and the results were correlated to histopathology. Conventional mammography and dynamic MRI yielded a sensitivity and specificity of 82 and 64 %, and 92 and 76 %, respectively. The difference between the results was statistically not significant (p > 0.05) with areas under the receiver-operating-characteristics curves of 0.807 for mammography and 0.906 for MR imaging. Combination of the results of both methods slightly increased the sensitivity for detection of breast cancer to 95 % but decreased specificity to 52 %. In this selected patient subset, including only patients referred for excisional biopsy, contrast-enhanced dynamic MRI proved more sensitive and specific than conventional mammography regarding the detection of malignancy. While a combination of both methods yields a slightly improved sensitivity, specificity is vastly reduced.
authors.affiliation: Department of Diagnostic Radiology, Zurich University Hospital, Rämistrasse 100, CH-8091 Zurich, Switzerland.
authors.forename: G M
authors.initials: GM
authors.lastname: Kacl
authors.forename: P
authors.initials: P
authors.lastname: Liu
authors.forename: J F
authors.initials: JF
authors.lastname: Debatin
authors.forename: E
authors.initials: E
authors.lastname: Garzoli
authors.forename: R F
authors.initials: RF
authors.lastname: Caduff
authors.forename: G P
authors.initials: GP
authors.lastname: Krestin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media; D005188:False Negative Reactions; D005260:Female; D005682:Gadolinium; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; D005682:Gadolinium; C072417:gadoterate meglumine